Diagnosis and application of biomarkers of acute renal injury in perioperative liver transplantation

Abstract

Acute kidney injury (AKI), is a common complication of patients undergoing liver transplantation, with a high incidence of AKI ranging 17-95% in the post-liver transplantation. Despite this assertion, timing and definition of AKI have been inaccurate and inconsistent, usually based on serum creatinine. Objective: 1. Evaluate the pattern of elevated biomarkers of renal injury in blood and urine, each collection period: preoperative before anesthesia (1) after the reperfusion portal (2), 3 hours after surgery (3), 18 hours after the surgery (4), 24 (5), and 48 hours after surgery (6) in relative to creatinine 2. Evaluate the incidence and outcome of patients who presented elevated levels of plasma creatinine and AKI criteria by KDIGO. 3. Evaluate the incidence and outcome of patients have positive biomarker and not have increase in plasma creatinine levels : Biomarker positive (BM +) and negative creatinine (Cr-), in compared to other groups (BM+/Cr+; BM-/Cr-; BM-/Cr+). 4. Evaluate the diagnosis of AKI based on novel biomarkers of kidney injury (based on literature data) and compare to the standard currently used, the elevation of creatinine (KDIGO). 5. Determine the biochemical characteristics and microscopic pattern of patients with BM+/Cr- e BM+/Cr+; BM-/Cr-; BM-/Cr+. 6. Evaluate mortality and its relation to: the donor data, the scales MELD, SAPS, SOFA, creatinine and kidney injury biomarker in the urine. Methodology: This is a cohort study, observational and prospective. Inclusion criteria are: signing the informed consent, agemore than 18 years old, patients preoperatively liver transplant, which will be assessed in microscopy, biochemical and urinary biomarkers urinary early AKI. (AU)